Carcinoma of the Anal Sac, part 2
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Updated: November 18th, 2019
In the last post, anal sac carcinoma was discussed, including diagnosing these malignant tumors in the dog. In this post, we will cover more on treatments and some data concerning outcomes.
If a guardian is coping with a diagnosis of canine anal sac carcinoma, often major questions arise soon after the news is received. Chemotherapy? Radiation? Diet? Supplements?
As a proponent of guardianship in dogs, my advice is always to get whatever data you can to use as rough guidelines for your particular dog. In this spirit, below is some information concerning survival statistics for dogs with anal gland carcinoma. Please remember that these numbers don’t apply to your dog necessarily, as they are calculated based on groups of different dogs.
One study showed the median survival time for dogs with treated tumors was 544 days overall. The upper limit of the range was up 1, 843 days! Those tumors that measured greater than or equal to 10 square cm was 292 days while those with smaller tumors had a median survival of 584 days. (A rough way for your vet to measure the square cm is to measure the radius of the tumor, square it, multiply this by 4, and multiply this by 3.14)
As to which treatment, it looks like the Big 3 conventional steps combined give the best survival chances. These are surgery, chemo and radiation. If you have to pick, go for the surgery as your minimum.
As usual, the additions of apoptogens, diet, immune support, anti-metastatic treatments, and life quality enhancement are a part of the Full Spectrum Plan provided in the Dog Cancer Survival Guide.
Best,
Dr D
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
Casey,
I am curious to what your regimen is. What you are feeding her and how much of the supplements, etc…
Thanks!
Thank you guys so much for sharing your information with me. It’s so overwhelming looking at all the material on the internet, reading and trying to make decisions especially since apocrine cancer isn’t addressed as much as one of the “major types” of cancer. I also wondered why no one had staged her cancer even with having all the results back from surgery, blood work, x-rays, ultrasound, and multiple doctors. Upon performing the ultrasound the radiologist found that although she didn’t have any visible signs of cancer, she had early stages of a mucocele gallbladder as well as multiple cysts in her kidney. She was more concerned about the gallbladder rupturing than the fact that we were scanning to see if the cancer had metastasized. So at this time it doesn’t look like doing treatments would be wise with her cysts and especially a gallbladder that could rupture. So I am looking into possible surgery for that and waiting for the results of additional blood work to come back. About seven weeks ago she completely stopped eating any commercial dog food. I tried just about everything but now I know that’s probably because the gallbladder. However, from what I read in the cancer book that may not be a bad thing. So I am going to start more with the cancer diet for now if I can get her to eat that. She is really picky. I am not sure what type of supplements I can give her with a gallbladder like this. I had ordered some of the APOCAPS and was going to get some of the K9 Immunity supplements but wasn’t sure how her gallbladder may react to that. So right now I am praying, treading water and being very thankful that at least I know what’s going on so that I may have a chance to help her. Thank you again so much for responding.
my dog was diagnosed august 2010 to have anal sac adenocarcinoma. once we found out the tumor (because of bleeding from her vagina), we decided to have it removed by surgery and then followed by three weeks of chemotherapy. chemo was terrible, she wouldn’t eat for a week so we decided to stop that. she lost a lot of weight and began to feel depressed. after a week she then came back to her normal being, we changed her diet to no grain and added supplements to her diet. one of the most important medicines that i think contributed to her being back to normal again was Artemisinin. with that, we also gave Transfer Factor, Vitamin E, milk thistle and CoQ10. she has this little cyst on her side, if she’s on her meds it flattens, if we don’t give her for a week it grows a little again. i got this regimen from my vet who had at least 2 patients take the regimen and tumor didn’t come back again. after several months, my dog had bleeding again from her vagina, it wasn’t UTI and it wasn’t from another tumor that might have came back. we had her spayed and all the bleeding was completely gone for about another 4 months. now, here she is having slight pinkish bleeding again from her urine, just like before. i wouldn’t know what the cause is, i’ll have to bring her to the vet again. but now she’s eating perfectly normal and behaving perfectly well, a dog who doesn’t seem to have cancer at all! she’s 5 years old and hoping to live another 5 or more years with her! any inputs on the cause of the bleeding will help. and if anyone needs the regimen, just let me know 🙂
all the best,
Casey
Ann
It sounds like your doing a wonderful job taking care of your baby. He’s very lucky to have you caring for him. It wasn’t my intention to suggest that chemo and radiation was the best, or the only strategy for treatment. I used chemo and then radiation with my boy, but NOT with my little girl. Emmy had the kidney issues so I was reluctant to use the chemo. She was diagnosed (anal sac carcinoma) about 1 1/2 yrs earlier than her brother and I used only the holistic route with her because of my concern for her kidneys. She did very well for several yrs with just the special diet and chinese herbs. It was later that I discovered that acupuncture would help with her blood pressure (I’m not sure if the blood pressure causes the kidney issue or the other way around?:). In time about 2 1/2 yrs after her cancer diagnosis the cancer spread to her spleen and liver. I’m not sure if she would have done better than that even with chemo treatment. So your little one will do fine….there isn’t a right or wrong decision about the choice for treatment. It’s just knowing the options…which took me some time to fully understand. With her brother who developed the same cancer I decided to do chemo and he did fine for a little while too. I was just frustrated with later seeing that we could have done more (seeing the oncology specialist and hearing all the options which should have included radiation). There’s no right way….I went two seperate routes because I happened to face the same cancer in a short period of time. I just wanted to pass on some of my experience so someone else may not have to start from scratch in gathering information. I had the unfortunate experience of losing 3 of my dogs within 6 months….my head was just spinning at the time, with trying to make decisions. I’m in Canada, and there wasn’t an oncologist in our province, so it was tough to get the most current info. That’s why the university was so helpful at the time….but they probably wouldn’t be on board with the holistic route. But I know from my experience it can work too.
I’m sorry if my emails were sounding judgemental. It wasn’t my intention. I think the topic may be still a little emotional for me. I know you’re making all the right decisions for your baby and..most importantly it sounds like he’s happy and enjoying life. The most important thing! And yes seeing lots of doctors and having treatments is very stressful for them.
I wish you the very best.
Kathy
Kathy, thanks for the information. I didn’t think about high blood pressure being the cause of the kidney problems. You are right Benazeril is used for high blood pressure. That wasn’t explained when we put him on the pills and I never thought to make the connection. After reading your other post I was feeling a bit guilty for not going the chemo route, but in my heart of hearts I know it would not have been the right decision for us. It is so difficult because you can’t explain it to them and is hard enough when it is a person who at some level can understand what may happen. out seems a city the size of where I live would be overrun with holistic vets but it isn’t or a vet school either. Although he does well going to his usual local vet when I was dragging him around to second opinion and onco he was stressed. So dragging him out of town to a strange smelling place would probably stress him even more. I understand stress is not a good thing so trying to keep that to a minimum (which gives you a very spoiled fur baby! But he deserves it!). It has been 4 months now since diagnosis and he still is running up and down the stairs, jumping on the bed, eating, wanting treats, going for walks and rides – acting normal. I am so thankful for the reprieve from what others have to deal with and for each “normal”day. Will continue the hunt for a holistic vet close by. Thanks again.
Ann
You could try to locate a Holistic vet who practices Traditional Chinese Medicine. There are several Chinese Herbs which are cancer fighters. They’re added to their food, just like the mushrooms etc. that you’re using now. In fact one of the herbs is a mushroom mix. This was helpful for my female (the sister of my boy I wrote about yesterday) who had anal sac carcinoma, as well. I was reluctant to use chemotherapy with her because she also had kidney problems. I have since learned that some chemo drugs don’t tax the kidneys as much as others. Carboplatin is considered to be one of the safer drugs for the kidneys.
You mentioned that your dog was taking Benazeril (?..not sure of the spelling) for his kidney problems. It sounds like he may have a similar kidney issue as my girl did. If he’s taking this drug to help lower his blood pressure..which may be part of the kidney issue. I discovered that acupuncture can also lower their blood pressure. I found a Holistic vet who helped with the herbs, and also was very good at acupuncture. She found a way to use acupuncture to lower my girls blood pressure. We still used the western drug, but we were able to keep her dose lower by supplementing with regular acupunture. It really worked.
Take care
Kathy
Hi Susan
I started to write you a message, and my computer just ate it, so if you end up with 2 , I apologize.
Maybe this time, I can be more to the point, and shorter. I had 2 dogs who ended up dying from anal sac carcinoma. I’d like to pass on some things I learned from their journeys.
First..find an oncologist or as I did…a veterinarian training hospital where they train oncology specialists. I started by working with local vets who meant well, but didn’t have the knowledge and expertise. The time lost was very detrimental.
I finally went to Washington State Veterinarian Training Hospital. The care and level of expertise there was phenominal. Anal sac carcinoma is a treatable cancer, but you have to work with someone who can provide the best assessment(very important!..just because the cancer isn’t visible elsewhere, doesn’t mean it isn’t there microscopically).
The university dr’s used an MRI to see the total picture, and we did several treatments of RADIATION therapy (some of my local dr’s ..who were internal medicine specialists, believed radiation treatment wasn’t used on this cancer…This was not true!) The radiation treatments were followed by LOW DOSE CHEMOTHERAPY TABLETS given by me at home. The radiation had few side effects..none really other than some hair loss.
Before going to the university hospital my boy received chemotherapy by IV from local vets (every 3 wks) but it was not very effective in the long term. Going to the university and having their assessment and state of the art treatment was crucial to his treatment. Unfortunately by the time I took him there the cancer had advanced significantly and the university was able to only give us another 6 months,,,but he was happy and much more comfortable during that time.
Also I had a specialist create a cancer diet for him, which I made. Diet is very important.
If you do end up giving your girl Iv chemotherapy every 3 weeks, (which may end up being the best for her) I found that an acupuncture treatment right afterwards, helped alleviate the side effects. And there are traditional Chinese medicine herbs that help too. Combine the western medicine with holistic medicine to compliment it.
I wish you and your girl the very best of luck. See a specialist, please. I travelled from Canada to Washington to see them and it was the best thing I did. And the cost was more reasonable than my local vets..because the University was a training facility. If you can’t get to them, see if they’ll work in a consulting role with your vet. You can beat this!
My thoughts are with you.
Kathy
My dog too was diagnosed on February 21 after having the tumor removed several weeks earlier. Removal was clean with narrow margins. He had xrays and ultrasound which came back normal including lymph nodes (hadn’t spread). The oncologist said that this type of cancer was not normally staged (which is different from what I am reading?) And recommended carboplatin treatments or palladia. At that point seeing that it hadn’t spread and with no real assurances of the chemo doing anything, we elected to not do chemo. I did change his diet to a no grain food but have to watch the protein due to kidney problems for which he takes benazeril (and throxin for thyroid). I have also been adding brocolli, shitake mushrooms and krill oil to his kibble. Today is 4 months since diagnosis and he seems to be doing fine, still running up and down stairs, going for short walks, riding in the car and dragging out toys to play. We did have a scare last week when a lump showed up in his “arm pit”, but fine needle aspiration indicated fat lump. Not sure what else to be doing.
Dear Ann,
I am sorry to hear that you have yet another dog with this disease. You should realize that different oncologists will do different things, but it does seem prudent to gauge the extent of spread, especially if late in the disease. I might suggest a mixed beta glucan supplement (I like the old K-9 immunity preparation without the flavoring and fish oil), apoptogens, and having a happy life with regular veterinary and oncologist follow up’s.
Best,
Dr D
That’s five treatments consisting of one treatment every three weeks.
I have a 9 year old spayed female beagle and on June 8th my dog had a tumor removed surgically along with her right anal gland. Upon surgery X-rays for lungs were fine, and there was no evidence that she had any enlarged lymph nodes. At this time we haven’t performed an ultrasound and plan to do so next week.. She went into surgery with a calcium level of 18 and on June 14th her calcium has come down to 11.8. My vet believes that they got all of the tumor and she is doing fine now; however, I am researching to see what options may be available as far treatments and experience with this type of tumor. I have copied and pasted below a copy of her histopathology report. Any information would be appreciated deeply, and would like to see what type of chemo you suggest or if you suggest that since the tumor is removed. My vet said that it was about the size of a gold ball. Thanks!.
Accession No.
Test Results Adult Reference Range L Normal H
Histopathology, Full Written Report (Antech Diagnostics)
Biopsy
DESCRIPTION:
This mass represents a malignant neoplasm originating from the
apocrine glands of the anal sac region. It consists of solid and
cystic nests of neoplastic glandular and ductal cells which are often
separated by a moderately dense fibrovascular stroma. Some lobules
contain compact areas of neoplastic cells exhibiting a low to moderate
level of mitotic activity. The mitotic rate is 4-6/10 hpf. Lymphatic
tumor emboli are seen near the anal sac which is included in the
sections. There is a background of mixed suppurative inflammation and
hemorrhage at several margins.
MICROSCOPIC FINDINGS: APOCRINE ADENOCARCINOMA, RIGHT ANAL AREA.
COMMENTS:
Apocrine tumors of this type often cause hypercalcemia through a
pseudoparathyroid effect. When present, hypercalcemia can be used as a
prognostic indicator. This neoplasm has metastatic potential.
Prognosis is guarded. Morphology is characteristic of an intermediate
to high grade malignancy which has metastatic potential. The lesion
is apparently excised with narrow (1-4 mm) margins. The potential for
recurrence is moderate to high.
P.S. I forgot to mention that my vet suggests doxirubicin treatments (5 treatments to be given every 3 weeks).